index

Melanoma with Contralateral Axillary SLN Drainage — Case Report Hub

One-line summary

Recurrent cutaneous melanoma, left side, in a patient with a left axillary SLNB ~20 years prior. Preoperative Tc-99m lymphoscintigraphy localised the sentinel node to the right (contralateral) axilla; intraoperative ICG fluorescence traced the aberrant lymphatic channel in real time, captured in full HD — a rare strength, since most published lymphatic-mapping figures in this vault’s literature are low-resolution nuclear medicine images, not clear optical footage of the channel itself. Standard dual-tracer practice at QVH — not a trial case. The case argues that ICG resolves anatomical detail (the channel’s course) that scintigraphy’s activity map alone cannot, in a rare aberrant-drainage pattern with an unusually long (~20-year) latency from the original surgery.

Start here

• Case Overview — the patient, presentation, findings, and what’s still missing for SCARE
• Open Questions — ✅ resolved: confirmatory framing, not ICG-alone
• Fact-Check Log — every correction made to the original notes, with sources
• SCARE 2025 Reporting Checklist — live 19-item checklist, linked to sections

Literature, by theme

• 🟢 Theme - ICG as SLNB Modality — can ICG alone/decisively localise sentinel nodes?
• 🔵 Theme - Contralateral and Aberrant Lymphatic Drainage — how often, and why, drainage crosses to the opposite side
• 🟣 Theme - Lymphatic Regeneration and Mechanism — the physiology underpinning rerouting

All literature notes

TABLE year AS "Year", journal AS "Journal", status AS "Status"
FROM "Literature"
SORT year DESC

Dataview note

The table above needs the community Dataview plugin installed. Without it, this just renders as an inert code block — every other link, tag and callout in this vault works with core Obsidian, no plugins required.

Graph view

Open the graph view (Ctrl/Cmd+G). This note should sit at the centre as the highest-degree node, with the three theme notes as secondary hubs and literature notes radiating outward — that’s the “medusa” shape. Right-click → Star this note to pin it centre-stage, and use the tag filter (tag:#paper) to isolate the literature layer if the graph gets busy.

Tag index

• #case — case-specific notes
• #theme — thematic hub notes
• #paper/icg — ICG technique papers
• #paper/contralateral-drainage — aberrant/contralateral drainage papers
• #paper/mechanism — lymphatic regeneration/mechanism papers
• #status/verified / #status/corrected / #status/no-access — fact-check state